Defiant, argumentative and tearful: STEPHEN GIBBS details how Joel Cauchi's psychiatrist squirmed in the spotlight as she was finally grilled over his deadly rampage
Joel Cauchi's psychiatrist went from argumentative to defiant before finally admitting she was wrong as her treatment of the Bondi Junction mass killer was again put under the spotlight on Wednesday.
Dr A - who cannot be identified for legal reasons - returned to the witness box in the State Coroners Court at Lidcombe where she repeatedly clashed with Sue Chrysanthou, SC, the barrister representing three of the families of Cauchi's victims.
It followed Dr A's statement on Tuesday where she said Cauchi's rampage stemmed from 'sexual frustration, pornography and hatred towards women' rather than his psychotic state.
Although Dr A withdrew her statement after conceding she had indulged in 'conjecture and speculation', she remained defiant on Wednesday.
At one point, Dr A told Chrysanthou, 'I don't think you have any degree in medicine', while being quizzed about Cauchi's mental health.
At another, Dr A objected to a question from Chrysanthou about Cauchi's schizophrenia by saying: 'That's not true, I have to educate you.'
Chyrsanthou: 'I don't want to be educated. I just want you to answer the question.'
By the time the psychiatrist was due to face re-examination by Peggy Dwyer, senior counsel assisting the coroner, Dr A, who took Cauchi off all anti-psychotic medications because he didn't like the side effects but remains adamant that she committed no errors in her treatment, was in tears and could not go on.
The lunch break was taken early so she could compose herself.
State Coroner Teresa O'Sullivan is investigating the shopping centre massacre on April 13 last year when 40-year-old knifeman Cauchi killed five women and one man.
The carnage ended only when Inspector Amy Scott arrived on the scene and shot Cauchi dead.
Those killed by Cauchi were shoppers Dawn Singleton, 25, Jade Young, 47, Yixuan Cheng, 27, Ashlee Good, 38, Pakria Darchia, 55 and security guard Faraz Tahir, 30.
The inquiry has previously heard that Cauchi was 'floridly psychotic' but Dr A, who treated him for eight years until 2020, rejected that assessment on Tuesday and denied she had failed in his care.
Dwyer: 'What would you say to the suggestion that you refuse to accept that Joel was psychotic on the 13th of April because you don't want to accept yourself the failings in your care of Joel?'
Dr A: 'I did not fail in the care of Joel. I refuse - I have no error on my behalf.'
On Wednesday, Dr A continued to deny any failings, having helped wean Cauchi off his anti-psychotic medication by July 2019.
Dr A's first day giving evidence had featured heated testimony during which she became irritated with Dr Dwyer's line of questioning, telling her to 'move on'.
She began her second stint in the witness box by apologising for her behaviour the previous day, admitting she had been 'short at times' with Dwyer during her testimony.
'That's because I am suffering from acute pain and on medication,' she said
Cauchi, who grew up in Toowoomba on Queensland's Darling Downs, had been diagnosed with schizophrenia as a teen and had been successfully treated for more than two decades.
Dr A gradually eased Cauchi off the two antipsychotic drugs he was taking - aripiprazole and clozapine.
After Cauchi ceased taking the drugs, his mother Michele contacted the psychiatrist's private clinic seven times raising concerns about possible signs of relapse.
Those signs included him leaving notes around their home about Satanic control, experiencing extreme obsessive-compulsive disorder and poor sleep.
Dr A previously told the court Cauchi had never been psychotic after he stopped taking aripiprazole and clozapine.
She believed he had first-episode schizophrenia, rather than chronic schizophrenia, because he had remained symptom-free while medicated.
In early 2020, near the start of the COVID-19 pandemic, Cauchi moved to Brisbane when he was completely cut off from psychiatric care.
Having discharging Cauchi to his Toowoomba general practitioner after he relocated to Brisbane, Dr A said there was nothing she could do to follow up his care.
Dwyer suggested on Tuesday that Dr A could have made a phone call.
'You could have done that, you just couldn't charge for it,' she said.
Dr A accepted she could have done that.
On Tuesday, Dr A had also said Cauchi could not have organised the stabbing spree if he was experiencing symptoms of schizophrenia.
'It might have been to do with frustration, sexual frustration, pornography and hatred towards women,' she said.
'That is my opinion.'
At the start of the inquest, the office in charge of the police investigation, Detective Chief Inspector Andrew Marks, said Cauchi did not appear to have been targeting women.
Chrysanthou, who is looking after the interests of the Singleton, Young and Good families, told Dr A on Wednesday her claims about Cauchi's mental state at the time of the attack had shocked and distressed her clients and was 'contrary to all the expert evidence'.
Dr A withdrew her earlier statement.
'It was conjecture on my part and I should not have said what I said,' she added.
Dr A saw no link between discovering in November 2019 that Cauchi had become obsessed with sex and watching pornography five months after he had stopped taking medication.
'I didn't see any connection between the two, I thought it was a new phenomenon,' Dr A said.
Dr A had not believed Cauchi was paranoid when he expressed concern about having contracted HIV after what she called a 'dangerous sexual encounter' with a prostitute.
'It was a reality-based fear,' she said.
When Dr A queried the relevance of another of Chyrsanthou's questions the barrister responded: 'Don't worry about the relevance of my questions, just answer them.'
Dr A told the court Cauchi had never shown an interest in knives or given her reason to think he might be contemplating violent acts.
After Chrysanthou's cross-examination of Dr A it was the turn of Ragni Mathur, SC, the barrister representing a general practitioner who had treated Cauchi.
While working through the psychiatrist's contact with that physician, Mathur felt obliged to tell her, 'take a breath', 'pause, pause', and 'Doctor, take a breath'.
'I was satisfied that I did the right thing,' Dr A said at the end of Mathur's questions.
Dr A's own barrister, Mark Lynch, had his client explain to the court she was never in a position to make Cauchi take medication if he did not want it.
'It's almost the patient's choice,' she said.
'We can't force them.'
Dr A said during her eight years treating Cauchi he had never showed any symptoms of psychosis or signs of being a risk to himself or anyone else.
Between December 2015 and February 2020 she had 47 appointments with Cauchi, other psychiatrists had seen him six times, and psychiatric nurses saw him on 77 occasions.
Dr A told Lynch she had never been asked to give evidence in a court or tribunal until called to this inquest.
Asked if she was doing her utmost to the tell the truth, she said: 'In here, definitely, definitely.'
It was after Lynch had finished with his client that Dr A broke down in tears.
When she resumed giving evidence following lunch it was under Dwyer's re-examination.
After a more than a day and a half of giving evidence, Dr A was asked by Dwyer if she was now prepared to defer to the opinion of experts that Cauchi was psychotic when he killed seven strangers.
After a long pause, Dr A finally said 'yes'.
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